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https://www.readbyqxmd.com/read/29725587/do-programs-for-runaway-and-homeless-youth-work-a-qualitative-exploration-from-the-perspectives-of-youth-clients-in-diverse-settings
#1
Marya Gwadz, Robert M Freeman, Alexandra H Kutnick, Elizabeth Silverman, Amanda S Ritchie, Charles M Cleland, Noelle R Leonard, Aradhana Srinagesh, Jamie Powlovich, James Bolas
Runaway and homeless youth (RHY) comprise a large population of young people who reside outside the control and protection of parents and guardians and who experience numerous traumas and risk factors, but few buffering resources. Specialized settings have developed to serve RHY, but little is known about their effects. The present cross-sectional qualitative descriptive study, grounded in the positive youth development approach and the Youth Program Quality Assessment model, addressed this gap in the literature...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29578550/training-residents-in-hospital-medicine-the-hospitalist-elective-national-survey
#2
Steven Ludwin, James D Harrison, Sumant Ranji, Bradley A Sharpe, Patrick Kneeland
As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understand the prevalence, objectives, and structure of hospitalist-focused rotations in the United States. Residency leaders from 82 programs responded (82%). The prevalence of hospitalist-focused rotations was 50% (41/82) with an additional 9 programs (11%) planning to start one...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29466559/association-of-faculty-entrustment-with-resident-autonomy-in-the-operating-room
#3
Gurjit Sandhu, Julie Thompson-Burdine, Vahagn C Nikolian, Danielle C Sutzko, Kaustubh A Prabhu, Niki Matusko, Rebecca M Minter
Importance: A critical balance is sought between faculty supervision, appropriate resident autonomy, and patient safety in the operating room. Variability in the release of supervision during surgery represents a potential safety hazard to patients. A better understanding of intraoperative faculty-resident interactions is needed to determine what factors influence entrustment. Objective: To assess faculty and resident intraoperative entrustment behaviors and to determine whether faculty behaviors drive resident entrustability in the operating room...
February 21, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29465461/resident-autonomy-in-the-operating-room-how-faculty-assess-real-time-entrustability
#4
Xiaodong Phoenix Chen, Amy M Sullivan, Douglas S Smink, Adnan Alseidi, Joan M Bengtson, Gifty Kwakye, John L Dalrymple
OBJECTIVE: This study aimed to identify the empirical processes and evidence that expert surgical teachers use to determine whether to take over certain steps or entrust the resident with autonomy to proceed during an operation. BACKGROUND: Assessing real-time entrustability is inherent in attending surgeons' determinations of residents' intraoperative autonomy in the operating room. To promote residents' autonomy, it is necessary to understand how attending surgeons evaluate residents' performance and support opportunities for independent practice based on the assessment of their entrustability...
February 20, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/28950992/what-factors-influence-attending-surgeon-decisions-about-resident-autonomy-in-the-operating-room
#5
Reed G Williams, Brian C George, Shari L Meyerson, Jordan D Bohnen, Gary L Dunnington, Mary C Schuller, Laura Torbeck, John T Mullen, Edward Auyang, Jeffrey G Chipman, Jennifer Choi, Michael Choti, Eric Endean, Eugene F Foley, Samuel Mandell, Andreas Meier, Douglas S Smink, Kyla P Terhune, Paul Wise, Debra DaRosa, Nathaniel Soper, Joseph B Zwischenberger, Keith D Lillemoe, Jonathan P Fryer
BACKGROUND: Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. METHODS: We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure...
September 23, 2017: Surgery
https://www.readbyqxmd.com/read/28882683/structured-operative-autonomy-an-institutional-approach-to-enhancing-surgical-resident-education-without-impacting-patient-outcomes
#6
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Dustin R Long, Haytham M A Kaafarani, Emil Petrusa, John T Mullen, Keith D Lillemoe, Roy Phitayakorn
BACKGROUND: Although barriers to granting surgical residents autonomy in the operating room are well described, few have proposed practical strategies to overcome these barriers. Our department adopted a multidisciplinary approach to develop a rotation that aimed to grant chief residents structured operative autonomy. In this study, we assess the feasibility of implementation, impact on patient safety, and educational benefit to residents after the program's pilot year. STUDY DESIGN: During a 1-month rotation, chief residents began cases alone using their own operative block time...
December 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28813236/ethics-and-intimate-sexual-activity-in-long-term-care
#7
Eran Metzger
A case is presented in which the staff of a long-term care facility discovers that the husband of a resident with dementia is engaged in sexual activity with her. The case illustrates a dilemma for long-term care facilities that create a home-like environment with a goal of maximizing residents' autonomy while ensuring their safety. An approach to assessing capacity to consent to intimate sexual activity is described, followed by guidelines that nursing homes can implement to support residents who wish to engage in sexual activity...
July 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#8
MULTICENTER STUDY
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28652920/perception-of-and-attitude-toward-ethical-issues-among-korean-occupational-physicians
#9
Junghye Choi, Chunhui Suh, Jong-Tae Lee, Segyeong Lee, Chae-Kwan Lee, Gyeong-Jin Lee, Taekjoong Kim, Byung-Chul Son, Jeong-Ho Kim, Kunhyung Kim, Dae Hwan Kim, Ji Young Ryu
BACKGROUND: Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. METHODS: An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28452626/swimming-against-the-tide-a-case-study-on-the-removal-of-conservatorship-and-guardianship
#10
Kyle S Page, Kate L M Hinrichs
OBJECTIVE: This article evaluates the role healthcare providers play in balancing safety versus autonomy among elders when performing capacity evaluations. METHODS: Presentation of a case study consisting of an 85-year-old, Caucasian, widowed, male, post-stroke veteran, residing in long-term care. He was assigned a permanent court-appointed joint guardian and conservator, but wanted to remove both of these as he felt he had the ability to manage his own affairs...
January 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28423148/increasing-resident-autonomy-without-compromising-patient-safety
#11
Rebecca L Gunter, Jacob A Greenberg
No abstract text is available yet for this article.
July 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28396631/transcranial-electrical-stimulation-to-enhance-cognitive-performance-of-healthy-minors-a-complex-governance-challenge
#12
REVIEW
Jantien W Schuijer, Irja M de Jong, Frank Kupper, Nienke M van Atteveldt
An increasing number of healthy adolescents are consuming products that can enhance their cognitive performance in educational settings. Currently, the use of pharmaceuticals is the most widely discussed enhancement method in the literature, but new evidence suggests that other methods based on Transcranial Electrical Stimulation (tES) also have potential as cognitive enhancer. Just like pharmaceutical enhancers, the availability and education-related use of tES-devices raise a broad range of ethical, legal, and societal issues that need to be addressed by policy-makers...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28349051/implementation-of-a-novel-structured-social-and-wellness-committee-in-a-surgical-residency-program-a-case-study
#13
Kathryn E Van Orden, Stephanie D Talutis, Joanna H Ng-Glazier, Aaron P Richman, Elliot C Pennington, Megan G Janeway, Douglas F Kauffman, Tracey A Dechert
This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28239211/active-subjects-of-passive-monitoring-responses-to-a-passive-monitoring-system-in-low-income-independent-living
#14
Clara Berridge
Passive monitoring technology is beginning to be reimbursed by third-party payers in the United States of America. Given the low voluntary uptake of these technologies on the market, it is important to understand the concerns and perspectives of users, former users and non-users. In this paper, the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. This includes experiences of adoption, non-adoption, discontinuation and creative 'misuse'. The analysis of interviews reveals three key insights...
March 2017: Ageing and Society
https://www.readbyqxmd.com/read/27886972/the-resident-run-minor-surgery-clinic-a-pilot-study-to-safely-increase-operative-autonomy
#15
REVIEW
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, Roy Phitayakorn
OBJECTIVE: General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27788377/individual-and-contextual-characteristics-of-indoor-and-outdoor-falls-in-older-residents-of-s%C3%A3-o-paulo-brazil
#16
Carla Ferreira do Nascimento, Yeda Aparecida Oliveira Duarte, Maria Lúcia Lebrão, Alexandre Dias Porto Chiavegatto Filho
PURPOSE OF THE STUDY: To analyze a representative sample of older individuals of São Paulo, Brazil, according to outdoor fallers, indoor fallers and non-fallers, and to identify biological and socioeconomic (individual and contextual) factors associated with the occurrence and place of falls. MATERIALS AND METHODS: A cross-sectional study was conducted using data (n = 1345) from the 2010 wave of the Health, Wellbeing and Aging (SABE) Study, a representative sample of older residents (60 years and older) of São Paulo, Brazil...
January 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27768393/care-home-manager-attitudes-to-balancing-risk-and-autonomy-for-residents-with-dementia
#17
Elizabeth A Evans, Elizabeth Perkins, Pam Clarke, Alina Haines, Ashley Baldwin, Richard Whittington
OBJECTIVE: To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. METHOD: Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach...
February 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/26934694/see-more-do-more-teach-more-surgical-resident-autonomy-and-the-transition-to-independent-practice
#18
Daniel A Hashimoto, William E Bynum, Keith D Lillemoe, Ajit K Sachdeva
The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs...
June 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/26692998/progressive-independence-in-clinical-training-perspectives-of-a-national-multispecialty-panel-of-residents-and-fellows
#19
Jeanne M Franzone, Benjamin C Kennedy, HelenMari Merritt, Jessica T Casey, Melissa C Austin, Timothy J Daskivich
BACKGROUND: Progressive independence in patient care activities is imperative for residents' readiness for practice and patient safety of those cared for by graduates of residency programs. However, establishing a standardized system of progressive independence is an ongoing challenge in graduate medical education. OBJECTIVE: We aggregated trainees' perspectives on progressive independence, developed a model of the ideal state, and suggested actionable improvements...
December 2015: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/26691924/young-surgeons-on-speaking-up-when-and-how-surgical-trainees-voice-concerns-about-supervisors-clinical-decisions
#20
Malini D Sur, Nancy Schindler, Puneet Singh, Peter Angelos, Alexander Langerman
BACKGROUND: Poor communication is a known contributor to disasters in aviation and medicine. Crew members are trained to raise concerns about superiors' plans, yet literature exploring surgical trainees' responses to analogous concerns is sparse. METHODS: Surgical residents were interviewed about approaches to concerns about supervisors' clinical decisions using a semistructured guide. Emerging themes were developed using the constant comparative method. RESULTS: Eighteen residents participated...
February 2016: American Journal of Surgery
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